Provider Demographics
NPI:1346058138
Name:HARRIS, WILLIAM D (RNFA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:HARRIS
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 FOX HOLW
Mailing Address - Street 2:
Mailing Address - City:IONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14475-9704
Mailing Address - Country:US
Mailing Address - Phone:585-233-1824
Mailing Address - Fax:
Practice Address - Street 1:350 PARRISH ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1793
Practice Address - Country:US
Practice Address - Phone:585-472-2447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-25
Last Update Date:2024-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY483654163W00000X, 208600000X, 163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No163W00000XNursing Service ProvidersRegistered Nurse
No208600000XAllopathic & Osteopathic PhysiciansSurgery